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Hormati A, Hajrezaei Z, Jazi K, Aslani Kolur Z, Rezvan S, Ahmadpour S. Gastrointestinal and Pancratohepatobiliary Cancers: A Comprehensive Review on Epidemiology and Risk Factors Worldwide. Middle East J Dig Dis 2022; 14:5-23. [PMID: 36619733 PMCID: PMC9489325 DOI: 10.34172/mejdd.2022.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 11/01/2021] [Indexed: 01/11/2023] Open
Abstract
A significant number of cancer cases are afflicted by gastrointestinal cancers annually. Lifestyle and nutrition have a huge effect on gastrointestinal function, and unhealthy habits have become quite widespread in recent decades, culminating in the rapid growth of gastrointestinal cancers. The most prevalent cancers are lip and mouth cancer, esophageal cancer, gastric cancer, liver and bile duct cancer, pancreatic cancer, and colorectal cancer. Risk factors such as red meat consumption, alcohol consumption, tea, rice, viruses such as Helicobacter pylori and Ebstein Bar Virus (EBV), along with reduced physical activity, predispose the gastrointestinal tract to damage and cause cancer. According to the rapid increase of cancer incidence and late diagnosis of gastrointestinal malignancies, further epidemiological researches remain necessary in order to make appropriate population-based preventive policies. In this study, we reviewed clinical symptoms, risk factors, preventative measures, as well as incidence and mortality rates of gastrointestinal malignancies worldwide with focus on Iranian population.
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Affiliation(s)
- Ahmad Hormati
- Assistant Professor of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran,Assistant Professor of Gastroenterology and Hepatology, Disease Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Zahra Hajrezaei
- Student Research Committee, Faculty of Medicine, Qom University of Medical Science, Qom, Iran
| | - Kimia Jazi
- Student Research Committee, Faculty of Medicine, Qom University of Medical Science, Qom, Iran
| | - Zahra Aslani Kolur
- Student Research Committee, Faculty of Medicine, Qom University of Medical Science, Qom, Iran
| | - Sajjad Rezvan
- Radiology Resident, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Sajjad Ahmadpour
- Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran,Corresponding Author: Sajjad Ahmadpour, MD Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran Telefax: + 98 2538105062
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Barbaro MR, Cremon C, Morselli-Labate AM, Di Sabatino A, Giuffrida P, Corazza GR, Di Stefano M, Caio G, Latella G, Ciacci C, Fuschi D, Mastroroberto M, Bellacosa L, Stanghellini V, Volta U, Barbara G. Serum zonulin and its diagnostic performance in non-coeliac gluten sensitivity. Gut 2020; 69:1966-1974. [PMID: 32060130 DOI: 10.1136/gutjnl-2019-319281] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 12/28/2019] [Accepted: 01/03/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Non-coeliac gluten sensitivity (NCGS) is characterised by intestinal and extraintestinal symptoms related to the ingestion of gluten-containing foods, in the absence of coeliac disease (CD) and wheat allergy. No biomarkers are available to diagnose NCGS and the gold standard double-blind placebo-controlled gluten challenge is clinically impractical. The aim of our work was to investigate the role of serum zonulin as a diagnostic biomarker of NCGS and to develop a diagnostic algorithm. DESIGN In a multicentre study, we enrolled 86 patients with either self-reported or double-blind confirmed NCGS, 59 patients with diarrhoea-predominant IBS (IBS-D), 15 patients with CD and 25 asymptomatic controls (AC). Zonulin serum levels were assessed and the associated diagnostic power calculated. Clinical and symptomatic data were recorded. The effect of diet on zonulin levels was evaluated in a subgroup of patients with NCGS. RESULTS Compared with ACs, the NCGS, irrespective of modality of diagnosis, and patients with CD had significantly increased levels of zonulin, as did both NCGS and patients with CD compared with participants with IBS-D. Self-reported NCGS showed increased zonulin levels compared with double-blind confirmed and not-confirmed NCGS. Six-month wheat avoidance significantly reduced zonulin levels only in HLA-DQ2/8-positive participants with NCGS. The diagnostic accuracy of zonulin levels in distinguishing NCGS from IBS-D was 81%. After exclusion of CD, a diagnostic algorithm combining zonulin levels, symptoms and gender improved the accuracy to 89%. CONCLUSION Zonulin can be considered a diagnostic biomarker in NCGS and combined with demographic and clinical data differentiates NCGS from IBS-D with high accuracy. Wheat withdrawal was associated with a reduction in zonulin levels only in NCGS carrying HLA genotype.
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Affiliation(s)
- Maria Raffaella Barbaro
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Emilia-Romagna, Italy
| | - Cesare Cremon
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Emilia-Romagna, Italy
| | | | - Antonio Di Sabatino
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Lombardia, Italy
| | - Paolo Giuffrida
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Lombardia, Italy
| | - Gino Roberto Corazza
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Lombardia, Italy
| | - Michele Di Stefano
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Lombardia, Italy
| | - Giacomo Caio
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Emilia-Romagna, Italy
| | - Giovanni Latella
- Department of Clinical Medicine Public Health Life Sciences and Environment, University of L'Aquila, L'Aquila, Abruzzo, Italy
| | - Carolina Ciacci
- Department of Medicine, Surgery, and Dentistry Scuola Medica Salernitana, University of Salerno, Salerno, Campania, Italy
| | - Daniele Fuschi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Emilia-Romagna, Italy
| | - Marianna Mastroroberto
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Emilia-Romagna, Italy
| | - Lara Bellacosa
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Emilia-Romagna, Italy
| | - Vincenzo Stanghellini
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Emilia-Romagna, Italy
| | - Umberto Volta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Emilia-Romagna, Italy
| | - Giovanni Barbara
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Emilia-Romagna, Italy
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